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2010 – 2011 Flu Clinics

2010 – 2011 Flu Clinics. August 26, 2010. Vaccine Administration. Codes 90465 Under age 8 injection 90467 Under age 8 intranasal 90471 Over age 8 injection 90473 Over age 8 intranasal Reimbursement Pays according to fee schedule (no longer capped at $8.00). Influenza Vaccine. Codes

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2010 – 2011 Flu Clinics

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  1. 2010 – 2011 Flu Clinics August 26, 2010

  2. Vaccine Administration Codes • 90465 Under age 8 injection • 90467 Under age 8 intranasal • 90471 Over age 8 injection • 90473 Over age 8 intranasal Reimbursement • Pays according to fee schedule (no longer capped at $8.00)

  3. Influenza Vaccine Codes • 90655 Preservative free, under age 3 • 90656 Under age 3 • 90657 Preservative free, over age 3 • 90658 Over age 3 • 90660 Intranasal, all ages Reimbursement • State Supplied $0.50 • Non-State Supplied AWP (Average Wholesale Price)

  4. Pneumococcal Vaccine Codes • 90732 - Adult or Immunosuppressed over age 2 for subcutaneous or intramuscular use • 90669 - Conjugate vaccine under age 5 for intramuscular use Reimbursement • State Supplied $0.50 • Non-State Supplied AWP (Average Wholesale Price)

  5. Physician Billing Information Physician Offices • Use appropriate claim form – 1500 or electronic submission. (No roster billing) • Bill administration code for all Influenza vaccines, State supplied and non-State supplied. • Bill the base CPT code for the State supplied vaccine. • No modifier required.

  6. Flu Clinic Amendments • Flu Clinics (Mass Immunizers) • Public Clinics should be listed on the State of RI website. • No longer able to support roster billing • Bill on CMS-1500 or electronic version thereof • Will contact each provider with billing ID number and revised contracts • Administration reimbursement is capped at $15.00

  7. Contacts Network Account Managers: • Janine Forrest (401)-732-7296 –Bristol Count,MA • Tom Morrisroe (401)732-7410 – Burrillsville, Central Falls, Cranston, Cumberland, Foster, Glocester Greenville, Harmony, Johnston, Lincoln, N Providence, N Smithfield, Scituate, Smithfield, Woonsocket AND Mass Immunizers • Wayne Marshall (401) 732-7562 – Barrington, Bristol, Charlestown, Coventry, East Greenwich, E Providence, Exeter, Hope Valley, Hopkinton, Jamestown, Kingston, Little Compton, Middletown, Narragansett, New Shoreham, Newport, N. Kingstown, Pawtucket, Portsmouth, Richmond, Riverside, Rumford, S. Kingstown, Tiverton, Wakefield , Warren , Warwick, W. Greenwich W Warwick and Westerly Provider Advocates: • Shannan Medeiros (401) 732-7115 • Nettierose Cooley (401) 732-7456

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